Intensive Virtual Treatment with Remote Abstinence Monitoring for Alcohol Use Disorder

The COVID-19 pandemic has had major impacts on both alcohol use and access to alcoholism treatment. For example, roughly a quarter of Canadians report increased alcohol consumption during the pandemic and there has been an increase in alcohol-related deaths among younger Canadians. At the same time, there has been a reduction in access to residential treatment (commonly known as rehabilitation or "rehab"), with evidence suggesting that the pandemic has led to greater delays in accessing residential treatment and poorer treatment retention. The transition to virtual care that has occurred during the pandemic offers the opportunity for high quality intensive care without the need for admission to a residential facility. The goal of the proposed pilot project is to assess the feasibility of a virtual intensive outpatient program for alcohol use disorder that aims to replicate the structure and abstinence monitoring of a residential treatment program. This virtual 4-week program at its core will consist of a 12-session manualized group cognitive behavioural therapy (delivered as 3 sessions per week) that has been demonstrated to reduce alcohol use. Participants will meet at least once per week with an addiction physician to ensure adequate medical management. Participants will be given Soberlink breathalyzers, which utilize facial recognition technology and internet connectivity to remotely monitor alcohol use. Individuals who are struggling to maintain abstinence will receive more intensive individual care (including more frequent physician and/or individual therapy appointments) during the program. Building an intensive virtual care program with remote abstinence monitoring offers the opportunity to address treatment barriers that have occured due to the pandemic by allowing high quality alcoholism care to be delivered at home. Furthermore, this program will reduce the need for brick-and-mortar facilities with 24/7 staffing requirements.